Is Therapy Covered by OHIP?
By everwell counselling
We know that navigating Ontario’s complex mental health care system can be daunting, so here’s some useful info that can help.
Making the decision to start therapy is stressful enough. Figuring out how to pay for it shouldn’t be an added stressor. That’s why we’ve put together this outline of what is and isn’t covered by the Ontario Health Insurance Plan - OHIP.
There is no easy answer to whether therapy is covered by OHIP. Sometimes yes, sometimes no…
Part of the problem in answering this question is that there are a number of different regulated health professionals who all offer therapy. These professionals have different training, educational backgrounds and titles. Plus, there are different words that people use to describe therapy: for example therapy, counselling, psychotherapy, or psychological therapy. All these terms refer to “talk therapy” as opposed to pharmacological or drug-based therapy. Drug-based therapy is covered by OHIP but if you’re looking for talk therapy, covered services are much harder to find . If you’re fortunate enough to have a job that offers an extended benefits plan, you may have therapy covered through this plan. But even then, this mix of public insurance (OHIP) and private insurance can be confusing. Let’s talk about OHIP therapy coverage in Ontario.
Yes
If you’re lucky enough to have a family doctor or a psychiatrist that provides counselling services, this will be covered by OHIP.
The Government of Ontario has encouraged family doctors to join together and form “one stop shop” teams for patients, which they call Family Health Teams or FHTs. Family Health Teams work out of the same building and provide a family doctor, as well as access to physiotherapy, dietitians, nurses, counsellors, and sometimes psychologists. In this case, talk therapy provided by any professional within the FHT is covered by public health insurance (OHIP in Ontario), and will not cost you anything. However, If your doctor is a solo practitioner working on their own, or they work in a walk-in clinic, they are not part of a FHT. If your doctor is part of a FHT we encourage you to call the office to inquire about their counselling services.
Other mental health care providers, such as psychologists, psychotherapists and social workers, may also be free if they work in government-funded hospitals, clinics or agencies..
Maybe
Talk therapy is covered by OHIP when done by a MD (such as a family doctor or a psychiatrist), or a Nurse Practitioner but…
Most family doctors or doctors at walk-in clinics do not have the training required, or the time to provide in-depth/ongoing psychotherapy. In Ontario there is a limited number of MDs who actually dedicate their practice to providing psychotherapy. Often, your doctor will refer you to others, such as a psychiatrist.
A referral to a psychiatrist must come from a doctor, and any therapy provided by a psychiatrist will be covered by OHIP. However, because of their education, some psychiatrists -not all - may emphasize drug therapies or a medical diagnosis which may or may not fit with with what you are looking for. Generally, visits with a psychiatrist may be once a month, or every few months, and may not offer the amount of in-depth support you are looking for.
No
Unfortunately, OHIP does not cover the services of a Registered Social Worker, Psychotherapist or Psychologist in private practice.
You may be asking yourself – what about Psychotherapists, Psychologists or Social Workers? Unless they work at a FHT, a hospital, or a government-funded agency, they won’t be covered by OHIP.
There are many Psychotherapists and Social Workers who offer their services to the public through private practice (including us, where we offer an Affordable Counselling program). This means that for these services there will be a fee for service.
Affordable counselling at everwell
At everwell, we believe in the importance of being able to offer services to everyone within our community. That’s why we have an Affordable Counselling program where our therapist interns (Master’s Degree students in Counselling Psychology) offer counselling as part of their required training before becoming registered Psychotherapists. This service is open to anyone looking for online counselling within Ontario. If you are interested in being connected to a therapist intern at everwell please click the link below to book a free consultation to get started.
More things to know…
The Ontario Ministry of Health and Long-Term Care does not currently track therapy wait times. But anecdotal evidence from patients, advocates and care providers suggests it can take weeks, months or even years to see a psychiatrist.
Although many family doctor’s offices or FHT now provide the services of a counsellor that can work with patients, thousands of Ontarians are caught between long wait times for publicly funded therapists and high costs for quick access to private ones.
Across Ontario, counsellors with master’s degrees in social work or psychology provide free or low-cost therapy at “community-based” mental health organizations. But community-based mental health resources have wait lists too… which means waiting a month or more before you can even talk to anyone.
How to access affordable mental health care in Ontario:
Talk to your doctor about what you’re experiencing — and they can either treat you directly or get you a referral to a psychiatrist, both of which are covered by OHIP.
Alternatively, you can set up an appointment with CouchMD where you can schedule a phone call with a physician in Ontario who can help guide you through your mental health struggles.
If you have insurance benefits through your employer, you will likely have some coverage. Check what types of counselling or other services are covered by your benefits plan. This could get you faster access to services.
If you don’t have your own insurance benefits, many therapists in private practice offer a sliding scale or affordable counselling by trainees (here’s where you can find low-cost online counselling in Ontario and Affordable Counselling).
There is a community organization for just about any mental health issue in Ontario. More broadly, there is a mental health helpline available through Connex Ontario (1-866-531-2600), and various services are provided by the Canadian Mental Health Association.
If you’re having an urgent mental health crisis, don’t wait. Go to the nearest emergency room or dial 911.
Want to know more?
Sources and Related Resources:
The Government of Ontario What OHIP covers
CAMH Looking for Mental Health Services
Toronto Star Timely, affordable mental health therapy out of reach for many
The Hamilton Spectator OHIP For All demands health care for all Ontario residents
Toronto Life The post-pandemic future: All mental health services will be covered under OHIP
Interested in booking your free consultation?
We provide virtual counselling with a human touch and make it easy to connect with a registered therapist. Contact us and let’s talk about whether online counselling at everwell is right for you.